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Florida Mutawakkil, RN, works with an
OR robotic system at Miami Cardiac and Vascular
Institute at Baptist Hospital.
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When Paula Graling, MSN, RN, a certified operating
room nurse and clinical nurse specialist at Inova Fairfax
Hospital in Falls Church, Va., first viewed the latest
cutting-edge operating room technology at a conference
in Florida 10 years ago, she felt amazed, a little overwhelmed
and a tiny bit concerned.
The computers in the laparoscopic surgery suite spoke,
announcing when everything was activated and ready.
The lighting system dimmed or brightened the room in
response to voice commands. Robots held cameras in place.
Video monitors showed clear, clean pictures of the simulated
model patient and procedure from all angles.
“I sat there in awe,” said Graling, national
treasurer for the Association of periOperative Registered
Nurses. “The first thing I thought was, ‘I’m
never going to get all these things together.’
”
In the back of her head was another, more unnerving
thought: “Am I going to be replaced by this thing?”
Today, she works in a hospital with six “Smart
Suites”—also called Endosuites, OR1s and
Operating Rooms of the Future, depending on which company
makes them—and three robots. Not only has she
mastered the new technology, she loves using it. It
still amazes her. But she no longer fears it could replace
real nurses.
“I’m never going to be replaced,”
she said. “The human component is something that
can’t be replaced.”
Operating room technology for noninvasive surgery has
exploded in the last five years as robots, voice-controlled
systems, sophisticated imaging equipment and tracking
techniques have been integrated with computer systems
to create operating rooms that practically run themselves.
The new technology is expensive, ever-changing and
requires more education, but generally it saves time,
creates less room for error and—with the machines
and monitors in the newest rooms now suspended from
ceiling booms—reduces the amount of pushing and
lifting nurses must do.
But the best feature of the new technology, perioperative
nurses say, is that it leaves them more time to do the
most important part of their job, the part no machine
can replace: caring and advocating for their patients.
Laparoscopic surgery has expanded to almost every corner
of the hospital. Orthopedic, endovascular, ophthalmology,
plastic surgery, neurosurgery, urology and general surgeries
are commonly performed using minimally invasive procedures.
Surgeries that once took 12 hours now take less than
three.
Leaps and bounds
As these surgeries have evolved, so has the technology
used to perform them. Surgeons use 3-millimeter endoscopes
and perform operations using high-resolution cameras
and video monitors. Robotic arms hold cameras and light
sources in place. Other robots, such as the da Vinci
Surgical System, actually perform surgery, manipulated
by the physician. With a patient’s permission,
surgical procedures can be broadcast to classrooms in
the hospital or copied onto DVDs to help educate students
or other patients.
The advance in OR technology that nurses perhaps appreciate
most has come in the setup and integration of the laparoscopic
surgery suite. Perioperative nurses say they expect
the new technology to become standard in operating rooms
and intensive care units within the next few years,
and eventually spread to the rest of the hospital.
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